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Current molecular and epidemiological studies could reveal individual families of Mycobacterium tuberculosis strains. The purpose of the present study was to reveal the spread of Mycobacterium tuberculosis strains of the family Beijing in the Samara Region and to define risk factors for their transmission. This was a cross-sectional populational molecular epidemiological study that showed that the Beijing genotype prevailed among the obtained isolates (66.6%; 586/880) and it was encountered among convicts and young persons (RR 1.3; 95% CI 1.2-1.5 and RR 1.2; 95% CI 1.0-1.3, respectively), which is indicative of active and recent transmission. Multifactorial analysis indicated that male sex (OR 1.5; 95% CI 1.1-1.9), younger age (OR 1.3; 95% CI 1.1-1.7), homelessness (OR 5.6; 95% CI 1.1-6.3), and prior or current confinement (OR 2.0; 95 CI 1.5-2.7) were substantially associated with the risk of contamination with the strain of the Beijung family. Drug resistance, including multidrug resistance, was twice higher among the strains of this family.

High rates of tuberculosis (TB) and HIV are believed to exist in Russian prisons. Prisoners with TB were studied in order to identify the following: 1) prevalence of HIV, and risk factors for HIV and other blood-borne virus infections; and 2) clinical and social factors that might compromise TB treatment effectiveness and/or patient adherence and, hence, encourage treatment failure. A 1-yr cross-sectional prevalence study of 1,345 prisoners with TB was conducted at an in-patient TB facility in Samara, Russian Federation. HIV and hepatitis B and/or C co-infection occurred in 12.2% and 24.1% of prisoners, respectively, and rates were significantly higher than in civilians. Overall, 48.6% of prisoners used drugs, of which 88.3% were intravenous users. Prisoners were more likely to be intravenous drug users and HIV positive compared with civilians with TB, and 40.2% of prisoners shared needles. Two-thirds of prisoners (68.6%) had received previous TB drug therapy (frequently multiple, interrupted courses) and were significantly more likely than civilians to have had previous therapy consistent with the high drug-resistance rates seen. Prisons are major drivers of the tuberculosis and HIV epidemics. Novel strategies are needed to reduce the spread of blood borne diseases, particularly in intravenous drug users.

Background: Clinical management of tuberculosis in Russia involves lengthy hospitalizations, in contrast to the recommended strategy advocated by the World Health Organization. Methods: We used Fourier transform, spectral analysis and Student's t-test to analyse periodic and seasonal variations in admission and discharge rates for tuberculosis hospitalizations in 1999-2002, using routinely captured data from the Samara Region, Russia. Results: Hospital admissions in colder months were significantly higher than in warmer months. The mean monthly adjusted number of admissions in colder and warmer months for all adults was 413 and 372 (P < 0.01), for unemployed adults 218 and 198 (P < 0.02) and for pensioners 104 and 82 (P < 0.05). Hospital discharges varied seasonally. Maximum differences between admissions and discharges occurred in colder months and minimum differences were observed in warmer months. Conclusions: As hospitalizations of tuberculosis patients in colder months fulfil an important social need, shifts to ambulatory care must be carefully managed. [ABSTRACT FROM AUTHOR]